RM_StatsStep 1 of 4Login InformationAlready a user? Login here Username *Email *Password *Password must be at least 7 characters long.Enter password again *Password must be at least 7 characters long.Step 2 of 4Student First Name *Middle NameStudent Last Name *Student Grade Level (Rising) *Select an option789101112Graduation YearSelect an option2019202020212022202320242025Student email address *Address Address Line 1 Address Line 2 City State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region Country Zip Date of Birth *Gender Male Female Hispanic or Latino? Yes No Ethnicity American Indian/Alaskan Asian/Pacific Islander Black Caucasian Hispanic Other Declined to Answer Have you ever enrolled at the University of La Verne? Yes No Emergency Contact InformationPrimary Parent/Guardian Name *Home PhoneWork PhoneCell Phone *GenderEmail AddressSecondary Parent/Guardian NameHome PhoneWork PhoneCell PhoneGenderEmail AddressStep 3 of 4Information for CEF SLICEDo you give CEF/SLICE permission to use your child's picture in promotional materials, including social media? Yes No Would you like University of La Verne to email you information about regarding enrollment? Yes No Please list any medical or allergy conditions the SLICE team should be made aware of.Does your student have an IEP and/or 504 plan? Yes No If your student has an IEP or 504 plan for behavioral or academic issues that our teachers should be aware of, please contact us at slice@supportcef.com Name of current school and school district? *I understand I must complete on-line Distance Learning Request Form for CUSD after class registration. Link will be sent to my email address. * Yes Step 4 of 4Class RegistrationClass Registration * Tech Ed Session 1 (GR 21) June 24-July 12, 2019 ($ 350) Tech Ed Session 2 (GR 21) July 15-August 2, 2019 ($ 350) Bodybuilding/Figure Control Session 1 (PE 31) June 24-July 12, 2019 ($ 350) Bodybuilding/Figure Control Session 2 (PE 32) July 15-August 2, 2019 ($ 350) Badminton/Phys Ed Session 1 (PE 51) June 24-July 12, 2019 ($ 350) Badminton/Phys Ed Session 2 (PE 52) July 15-August 2, 2019 ($ 350) Choose one or more summer courses for creditRequest for Official Transcripts ($10 per copy requested)Students must present a copy of their transcript to their high school in order to earn high school credit for these courses. University of LaVerne's policy is to charge a $10 processing fee per official transcript. Learn more here. Check box if you would like transcript Number of Transcripts Requested ($ 10) × Send Transcript(s) to this Address Address Line 1 Address Line 2 City State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region Country Zip Please log back in after payment for account, class registration and payment history! Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
